气管支气管淋巴结结核146例临床分析

Clinical analysis of 146 cases with tracheobronchial lymph node tuberculosis

目的探讨气管支气管淋巴结结核146例l临床特点。方法我院1998年～2007年10年间住院患者146例临床特点X线所见及诊断，进行同顾性分析。结果本组病例，男性84例，占57．3％，女性62例，占42．7％，男女之比1．4：1。20岁以下118例，占80．8％，其中15岁以下84例占57．5％，儿童占半数以上。青中年发病20％左右，有增多趋势，病程平均4．8个月，早期无明显症状。主要症状以发热、盗汗、乏力等占80％以上，其次为咳嗽、干咳为主，咳痰、胸痛、气短消瘦等症状均占50％左右，咯血59．6％，并发症以肺不张为最多26／82例31．7％，其次为继发性肺结核22／82例26．9％，结核性空洞13／82例15．9％，结核性胸膜炎12／82例14．6％，肺气肿9／82例11％等。本组病例发病部位及形态，肺门62．3％，气管旁39．7％，形态分炎症型45．9％，结节型54．1％，本组病例年龄和病变大小的关系：病变以2．0～3．5cm123例为最多占84．2％，年龄以6～20岁病变较大106例72．6％，痰结核菌阳性21例14．4％，PPD试验阳性和强阳性78．1％，对诊断有重要意义。经抗结核治疗总有效率95．2％，疗效甚佳。结论早诊断、合理化疗、化疗时间适当延长1．5—2年为宜，可收到较满意疗效。

Objective To investigate the tracheobronchial lymph nodes of clinical characteristics of 146 cases with tuberculosis. Methods The study subjects were 146 inpatients in our hospital between 1998 and 2007. The data of the patients＇clinical characteristics of X-ray findings and diagnosis were retrospectively analyzed. Results 84 cases were men, accounting for 57.3% , and 62 cases were women, accounting for 42.5 %. Male to female ratio was 1.4 ： 1. 118 cases were below 20 years old, accounting for 80. 8% , of which 84 cases were below 15 years old, accounting 57.5 %, and half of them were children. Young and middle-aged incidence was around 20%. There was a growing trend,with an average of 4. 8 months duration. The clinical symptoms were fever, sweating, fatigue and other symptoms in more than 80% of the cases, followed by cough, mainly dry cough, sputum, chest pain, shortness of breath symptoms such as weight （：50%）. Hemoptysis accounted for 59.6%, with complications to a maximum of atelectasis in 26/79 cases（33% ）, followed by quarter-onset pulmonary tuberculosis of 28% （ 22/79 ） , tuberculous cavity, （ 10/79,14% ） , tuberculous pleurisy （ 14% ） , emphysema（ 8/79,10% ）. The incidence of cases in terms of location and shape was as follows：hilar ：62. 3%, rachea： （39.7%） ,inflammatory form of sub-accounts： 45. 9%,and nodular type：54. 1%. In terms of the relationship between age and size：lesion between 2.0 cm and 3.5 cm 123 cases （84.2%）, age 6 to 20 years old： 106 cases, 72.6%, sputum TB 21 cases of positive bacteria （ 14.4% ）. The PPD-positive and strongly positive tests accounted for 78. 1%, which was important to the diagnosis. Anti-tuberculosis treatment had the total effective rate of 95.2%, with good effect. Conclusion It is important to have early diagnosis and rational chemotherapy,with the extension of treatment time to ap- propriately 1.5 to 2 years,in order to achieve satisfactory effect.